| NPI | 1386152080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AR OTR4039) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AR OT-A1320) |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2025-01-03 |